AJLM2501 - CME/CMLE - External quality assessment in African clinical laboratories: A systematic review and meta-analysis-External quality assessment in African clinical laboratories: A systematic review and meta-analysis

External quality assessment in African clinical laboratories: A systematic review and meta-analysis

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This systematic review and meta-analysis, published in the American Journal of Clinical Pathology, examines the performance of clinical laboratories in Africa concerning External Quality Assessment (EQA). EQA is a tool used to measure and improve laboratory testing quality by comparing results against a standard or peer group. The study synthesizes pooled EQA performance data of African laboratories using data from various databases and gray literature.<br /><br />The study reviewed 17 articles involving 4,509 participating laboratories. These laboratories achieved an overall pooled EQA performance of 71.25%, falling short of the 80% standard typically recommended. The review highlights significant publication bias and heterogeneity in the performance data, particularly among different types of laboratory tests and EQA methods. For instance, immunology tests scored higher (79.66%) compared to malaria testing (53.47%). The results indicate a need for continuous improvement in laboratory quality management systems across Africa.<br /><br />The analysis identifies several challenges that contribute to the performance gap, such as discrepancies in infrastructure, poor participation, and financial constraints hindering consistent engagement in EQA programs. These challenges affect the transport and timely shipment of EQA samples, significantly impacting laboratory performance.<br /><br />The study recommends sustained investment in quality management systems and participation in EQA programs to enhance laboratory standards. It also calls for further research to understand better the factors influencing laboratory performance and promote frameworks supporting laboratory accreditation and consistent quality improvements.<br /><br />Despite limitations such as language restrictions and excluding qualitative studies, this review provides critical insights into the EQA performance of laboratories in Africa and the need for continuous efforts to achieve and maintain high-quality laboratory standards across the continent.

Keywords

systematic review

meta-analysis

clinical laboratories

External Quality Assessment

Africa

laboratory testing quality

publication bias

quality management systems

laboratory accreditation

performance improvement